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23 Cards in this Set
- Front
- Back
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dilated cardiomyopathy. tx? dx testing? causes?
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tx: ACEI/ARBs, BB, and spironolactone (just like systolic CHF)
Dx: echo to look for EF and wall motion activity causes: alcohol, adriamycin, radiation, Chaga'sdisease |
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Shortness of breath on exertion and an S4 gallop. 1. Suspect?
2. dx testing? 3. tx? |
1. hypertrophic cardiomyopathy
2. Echo 3. Tx: BB and diuretics Note: S4 is sign of left vent hypertrophy |
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Dyspnea w/ increase in JVP on inhalation and history of sarcoidosis, amyloidosis, hemochromatosis, ancer, myocardial fibrosis, or glycogen storage DO. low voltage EKG. Dx? tx
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Restrictive cardiomyopathy
Kussmaul's sign dx w/ echo, determine etiology w/ endomyocardial biopsy tx: diuretics and tx underlying dz |
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Chest pain that changes with respiration and is relieved by sitting up and leaning forward. friction rub on exam w/ NORMAL BP, NO: JVP, organomegaly, edema, tenderness to palpation.
1. think? 2. dx how? 3. tx 4. if pain persists? |
1. pericarditis
Note: pleuritic pain changes with respiration Note: Positional chest pain: relieved by sitting up and leaning forward 2. dx w/:EKG 3. tx: NSAIDS. if pain persists add prdnisone orally w/ colchicine |
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dyspnea, hypotension, and jugular venous distention w/ clear lungs. Blood pressure decreases >10mmHG on inhalation. EKG shows alterations of the axis of the QRS. Think? What do you see on echo? tx? Avoid?
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pericardial tamponade
dx test: echo shows diastolic collapse of the right atrium and ventrical tx: 1. pericardiocentesis 2. followed by pericardial window placement AVOID diuretics |
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dyspnea, edema, JVD, hepatosplenomegaly, ascites. Exam: increase in JVP on inhalation and pericardial knock.
1. think? 2. dx testing? 3. tx? |
1. Constrictive pericarditis
pericardial knock is an extra diastolic sound from the heart hitting a calcified thickened pericardium 2. testing: ekg: low voltage CXR: calcification MRI/CT: thickening of the pericardium 3. tx: 1. diuretics; 2. followed by surgical removal of the pericardium |
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edema, JVD, hepatosplenomegaly, ascites
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signs of chronic right heart failure
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severe ripping chest pain that radiates to the back w/ hypertension
1. best initial test? 2. most accurate test? tx? consult who admit where |
1. CXR shows a widened mediastinum
2. CT angio=TEE=MRI tx: BB, EKG, CSR, nitroprusside to control BP (relaxes vascular smooth muscle and decreases afterload and preload) consult surg admit to ICU |
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pain in the calve on exertion +/- smooth, shiny skin w/ hair loss and sweat gland loss, loss of pedal pulses. think?
1. best initial test? 2. most acurate test 3. tx |
peripheral arterial disease
1. ankle brachial index ( a noraml ABI should be >=0.9 as BP in legs should be equal to or greater than pressure in the arms) if >10% differenc -> obstruction 2 angiography tx: ASA, ACE I, exercise cilostazol: vasodilator and platelet inhibitor statin if LDL >100 |
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signs that afib is unstable? tx?
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systolic bp<90,
congestive failure, chest pain new confusion tx: stat synchronized cardioversion without echo |
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stable afib tx?
rate? 1. anticoagulation when? 2. Choice of anticoagulation? |
rate <110 w/:
* BB: metoprolol or esmolol * Calcium channel blocker: diltiazem * digoxin 1. anticoagulation when afib lasts longer than 2 days 2. CHADS2 >=2: warfarin or dabigatran (Pradaxa) CHADS2 <2: ASA |
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aflutter tx
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same as afib
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afib or flutter tx if pt has asthma?
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calcium channel blocker: diltiazem (cardizem)
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afib or flutter tx if pt has migraines?
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calcium channel blocker: diltiazem (cardizem)
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afib or flutter tx if pt has borderline hypotension?
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digoxin because it is ionotropic as well as a rate controlling medication
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syncope w/ sudden loss of consciousness. etiology (2)
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cardiac or
neurologic (seizures) |
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syncope w/ gradual loss of consciousness. etiology?
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drugs, hypoxia, metabolic (hypoglycemia)
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syncope w/ sudden regaining of consciousness. etiology
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cardiac
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syncope w/ gradual regaining of consciousness. etiology
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neurologic
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syncope w/ sudden loss of consciousness, sudden regaining of consciousness, and normal cardiac exam. 1. Think?
2. tx? |
ventricular arrhythmia
implantable cardioverter/defibrillator |
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syncope w/ sudden loss of consciousness, sudden regaining of consciousness, and ABnormal cardiac exam.
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structural heart disease
- AS -HOCM - mitral stenosis |
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spironolactone effect on heart failure
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prevents remodeling that occurs as compensation for the progressive failure of the heart
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ACE I actions on the heart
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- decrease vascular resistance, venous tone and blood pressure -> decreased preload and afterload -> increased CO
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